File Version:
L, CCW Data Documentation February 2021
NumberSAS NameVariable Name
1 BENE_ID Encrypted CCW Beneficiary ID
2 CLM_ID Claim ID
3 NCH_NEAR_LINE_REC_IDENT_CD NCH Near Line Record Identification Code (RIC)
4 NCH_CLM_TYPE_CD NCH Claim Type Code
5 CLM_FROM_DT Claim From Date (FFS)
6 CLM_THRU_DT Claim Through Date (FFS)
7 NCH_WKLY_PROC_DT NCH Weekly Claim Processing Date
8 CARR_CLM_ENTRY_CD Carrier Claim Entry Code
9 CLM_DISP_CD Claim Disposition Code
10 CARR_NUM Carrier or MAC Number
11 CARR_CLM_PMT_DNL_CD Carrier Claim Payment Denial Code
12 CLM_PMT_AMT Claim (Medicare) Payment Amount
13 NCH_PRMRY_PYR_CLM_PD_AMT NCH Primary Payer (if not Medicare) Claim Paid Amount
14 CARR_CLM_PRVDR_ASGNMT_IND_SW Carrier Claim Provider Assignment Indicator Switch
15 NCH_CLM_PRVDR_PMT_AMT NCH Claim Provider Payment Amount
16 NCH_CLM_BENE_PMT_AMT NCH Claim Payment Amount to Beneficiary
17 NCH_CARR_CLM_SBMTD_CHRG_AMT NCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)
18 NCH_CARR_CLM_ALOWD_AMT NCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)
19 CARR_CLM_CASH_DDCTBL_APLD_AMT Carrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)
20 CARR_CLM_HCPCS_YR_CD Claim Healthcare Common Procedure Coding System (HCPCS) Year Code
21 PRNCPAL_DGNS_CD Claim Principal Diagnosis Code (FFS)
22 PRNCPAL_DGNS_VRSN_CD Claim Principal Diagnosis Version Code (FFS)
23 ICD_DGNS_CD1 Claim Diagnosis Code I (FFS)
24 ICD_DGNS_VRSN_CD1 Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
25 ICD_DGNS_CD2 Claim Diagnosis Code II (FFS)
26 ICD_DGNS_VRSN_CD2 Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
27 ICD_DGNS_CD3 Claim Diagnosis Code III (FFS)
28 ICD_DGNS_VRSN_CD3 Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
29 ICD_DGNS_CD4 Claim Diagnosis Code IV (FFS)
30 ICD_DGNS_VRSN_CD4 Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
31 ICD_DGNS_CD5 Claim Diagnosis Code V (FFS)
32 ICD_DGNS_VRSN_CD5 Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
33 ICD_DGNS_CD6 Claim Diagnosis Code VI (FFS)
34 ICD_DGNS_VRSN_CD6 Claim Diagnosis Code VI Diagnosis Version Code (ICD-9/ICD-10) (FFS)
35 ICD_DGNS_CD7 Claim Diagnosis Code VII (FFS)
36 ICD_DGNS_VRSN_CD7 Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
37 ICD_DGNS_CD8 Claim Diagnosis Code VIII (FFS)
38 ICD_DGNS_VRSN_CD8 Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
39 ICD_DGNS_CD9 Claim Diagnosis Code IX (FFS)
40 ICD_DGNS_VRSN_CD9 Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
41 ICD_DGNS_CD10 Claim Diagnosis Code X (FFS)
42 ICD_DGNS_VRSN_CD10 Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
43 ICD_DGNS_CD11 Claim Diagnosis Code XI (FFS)
44 ICD_DGNS_VRSN_CD11 Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
45 ICD_DGNS_CD12 Claim Diagnosis Code XII (FFS)
46 ICD_DGNS_VRSN_CD12 Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
47 RFR_PHYSN_UPIN Carrier/DMERC Claim Ordering Physician UPIN Number
48 RFRG_NPI Claim Referring Physician NPI Number
49 CLM_CLNCL_TRIL_NUM Clinical Trial Number
50 DOB_DT Date of Birth from Claim
51 GNDR_CD Gender Code from Claim
52 BENE_RACE_CD Beneficiary Race Code (FFS)
53 BENE_CNTY_CD County Code from Claim (SSA)
54 BENE_STATE_CD Beneficiary Residence (SSA) State Code (FFS)
55 BENE_MLG_CNTCT_ZIP_CD Zip Code of Residence from Claim
56 ACO_ID_NUM Claim Accountable Care Organization (ACO) Identification Number
57 CLM_BENE_ID_TYPE_CD Claim Beneficiary Identifier Type Code
58 CLM_RSDL_PYMT_IND_CD Claim Residual Payment Indicator Code

LINE FILE

NumberSAS NameVariable Name
1 BENE_ID Encrypted CCW Beneficiary ID
2 CLM_ID Claim ID
3 CLM_LINE_NUM Claim Line Number
4 NCH_CLM_TYPE_CD NCH Claim Type Code
5 CLM_THRU_DT Claim Through Date (FFS)
6 TAX_NUM Line Provider Tax Number
7 PRVDR_SPCLTY Line CMS Provider Specialty Code
8 PRTCPTNG_IND_CD Line Provider Participating Indicator Code
9 LINE_SRVC_CNT Line Service Count (FFS)
10 LINE_CMS_TYPE_SRVC_CD Line CMS Type Service Code
11 LINE_PLACE_OF_SRVC_CD Line Place Of Service Code (FFS)
12 LINE_1ST_EXPNS_DT Line First Expense Date (FFS)
13 LINE_LAST_EXPNS_DT Line Last Expense Date (FFS)
14 HCPCS_CD Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
15 HCPCS_1st_mdfr_cd HCPCS Initial Modifier Code (FFS)
16 HCPCS_2ND_MDFR_CD HCPCS Second Modifier Code (FFS)
17 HCPCS_3RD_MDFR_CD HCPCS Third Modifier Code (FFS)
18 HCPCS_4TH_MDFR_CD HCPCS Fourth Modifier Code (FFS)
19 BETOS_CD Line Berenson-Eggers Type of Service (BETOS) Code
20 LINE_NCH_PMT_AMT Line NCH Medicare Payment Amount
21 LINE_BENE_PMT_AMT Line Payment Amount to Beneficiary
22 LINE_PRVDR_PMT_AMT Line Provider Payment Amount
23 LINE_BENE_PTB_DDCTBL_AMT Line Beneficiary Part B Deductible Amount
24 LINE_BENE_PRMRY_PYR_CD Line Primary Payer Code (if not Medicare)
25 LINE_BENE_PRMRY_PYR_PD_AMT Line Primary Payer (if not Medicare) Paid Amount
26 LINE_COINSRNC_AMT Line Beneficiary Coinsurance Amount
27 LINE_PRMRY_ALOWD_CHRG_AMT Line Primary Payer Allowed Charge Amount
28 LINE_SBMTD_CHRG_AMT Line Submitted Charge Amount
29 LINE_ALOWD_CHRG_AMT Line Allowed Charge Amount
30 LINE_PRCSG_IND_CD Line Processing Indicator Code
31 LINE_PMT_80_100_CD Line Payment 80% / 100% Code
32 LINE_SERVICE_DEDUCTIBLE Line Service Deductible Indicator Switch
33 LINE_ICD_DGNS_CD Line Diagnosis Code
34 LINE_ICD_DGNS_VRSN_CD Line Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10)
35 LINE_DME_PRCHS_PRICE_AMT Line DME Purchase Price Amount
36 PRVDR_NUM DMERC Line Supplier Provider Number
37 PRVDR_NPI DMERC Line Item Supplier NPI Number
38 DMERC_LINE_PRCNG_STATE_CD DMERC Line Pricing State Code (SSA)
39 PRVDR_STATE_CD NCH Provider SSA State Code
40 DMERC_LINE_SUPPLR_TYPE_CD DMERC Line Supplier Type Code
41 DMERC_LINE_SCRN_SVGS_AMT DMERC Line Screen Savings Amount
42 DMERC_LINE_MTUS_CNT DMERC Line Miles/Time/Units/Services (MTUS) Count
43 DMERC_LINE_MTUS_CD DMERC Line Miles/Time/Units/Services (MTUS) Indicator Code
44 LINE_HCT_HGB_RSLT_NUM Hematocrit/Hemoglobin Test Results
45 LINE_HCT_HGB_TYPE_CD Hematocrit/Hemoglobin Test Type Code
46 LINE_NDC_CD Line National Drug Code (NDC) (FFS)
61 LINE_RSDL_PYMT_IND_CD Line Residual Payment Indicator Code
62 LINE_RP_IND_CD Line Representative Payee (RP) Indicator Code
63 DMERC_LINE_FRGN_ADR_IND Line Foreign Address Indicator
64 LINE_RR_BRD_EXCLSN_IND_SW Line Railroad Board Exclusion Indicator Switch
65 LINE_VLNTRY_SRVC_IND_CD Line Voluntary Service Indicator Code

Demonstrations/Innovations Code File

NumberSAS NameVariable Name
1 BENE_ID Encrypted CCW Beneficiary ID
2 CLM_ID Claim ID
3 NCH_CLM_TYPE_CD NCH Claim Type Code
4 DEMO_ID_SQNC_NUM Demonstration sequence number
5 DEMO_ID_NUM Demonstration number
6 DEMO_INFO_TXT Demo information text